| NPI | 1770973950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 64512) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 64512) |
| Enumeration Date | 2015-01-27 |
| Last Update Date | 2025-02-05 |