| NPI | 1720415953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NV 16113) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 55302) |
| 183500000X Pharmacist (Licence: NV 16113) | |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2022-06-20 |