| NPI | 1811203474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 60539) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 60539) |
| Enumeration Date | 2010-08-20 |
| Last Update Date | 2016-04-23 |