| NPI | 1720276280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302029135) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 60605) |
| 183500000X Pharmacist (Licence: FL PS30631) | |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MI 5305029135) | |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2025-02-04 |