| NPI | 1790099901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 16051-040) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CO 19413) |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2024-06-12 |