| NPI | 1801898069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: CA RPH 38533) |
| Additional Taxonomies | 1835N1003X Pharmacist Nutrition Support (Licence: CA RPH 38533) |
| 183500000X Pharmacist (Licence: CA RPH 38533) | |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2010-08-28 |