| NPI | 1942028980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NC 700558) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 23274) |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2025-01-07 |