| NPI | 1942445531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TX 44577) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: TX 1152) |
| Enumeration Date | 2008-12-10 |
| Last Update Date | 2008-12-10 |