| NPI | 1760821730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR 0008792) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 027329) |
| 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OR 0008792) | |
| Enumeration Date | 2013-06-22 |
| Last Update Date | 2017-05-25 |