| NPI | 1710409651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835N1003X Pharmacist, Nutrition Support (Licence: MI 5302037518) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302037518) |
| 1835G0303X Pharmacist, Geriatric (Licence: MI 5302037518) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: MI 5302037518) | |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: MI 5302037518) | |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2022-07-21 |