| NPI | 1881099679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WV RP0008957) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0008957) |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2026-06-04 |