| 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 | 1835N1003X Pharmacist, Nutrition Support (Licence: TX 54892) |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: TX 54892) | |
| 1835P1300X Pharmacist, Psychiatric (Licence: TX 54892) | |
| 163WD0400X Registered Nurse, Diabetes Educator (Licence: TX 54892) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: TX 54892) | |
| 1835P0200X Pharmacist, Pediatrics (Licence: TX 54892) | |
| 1835G0303X Pharmacist, Geriatric (Licence: TX 54892) | |
| 183500000X Pharmacist (Licence: TX 54892) | |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2026-03-16 |