| NPI | 1770824906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OR 0014114) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 19889) |
| 183500000X Pharmacist (Licence: NC 22573) | |
| Enumeration Date | 2013-03-13 |
| Last Update Date | 2023-04-25 |