| NPI | 1891164364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CO PHA.1121142) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0014908) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2026-02-23 |