| NPI | 1689115941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 77572) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 77572) |
| 183500000X Pharmacist (Licence: NV 19496) | |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2018-11-07 |