| NPI | 1770841603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302036465) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MI 5302036465) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: MI 5302036465) | |
| Enumeration Date | 2012-04-28 |
| Last Update Date | 2024-02-13 |