| NPI | 1932481991 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OR 7685)  | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR 7685)  | 
| Enumeration Date | 2011-09-15 | 
| Last Update Date | 2018-06-16 |