| NPI | 1891752317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MA 15327) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 15327) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: MA 15327) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2014-12-12 |