| NPI | 1902241748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TX 41385) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 14920) |
| 183500000X Pharmacist (Licence: FL PS35610) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: LA 016710) | |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2013-05-07 |