| NPI | 1730675430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TX 54892) |
| Additional Taxonomies | 163WD0400X Registered Nurse Diabetes Educator (Licence: TX 54892) |
| 183500000X Pharmacist (Licence: TX 54892) | |
| 1835G0303X Pharmacist Geriatric (Licence: TX 54892) | |
| 1835N1003X Pharmacist Nutrition Support (Licence: TX 54892) | |
| 1835P1300X Pharmacist Psychiatric (Licence: TX 54892) | |
| 1835P2201X Pharmacist Ambulatory Care (Licence: TX 54892) | |
| 1835P0200X Pharmacist Pediatrics (Licence: TX 54892) | |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: TX 54892) | |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2022-05-19 |