| NPI | 1740792985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: AL 15992) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: FL 37677) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: AL 15992) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: FL 37677) | |
| Enumeration Date | 2017-10-27 |
| Last Update Date | 2017-10-27 |