| NPI | 1770051534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 79870) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: CA 79870) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 79870) | |
| 1835C0207X Pharmacist, Compounded Sterile Preparations (Licence: CA 79870) | |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2026-04-24 |