| NPI | 1780117689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835G0303X Pharmacist Geriatric (Licence: VA 2867) |
| Additional Taxonomies | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TX 45500) |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: DC 3150895) | |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2017-04-07 |