| NPI | 1760776157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MD 12341) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DE A1-0002390) |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2021-03-17 |