| NPI | 1942500921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 37541) |
| Additional Taxonomies | 1835N1003X Pharmacist Nutrition Support (Licence: CA 37541) |
| 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 37541) | |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2010-10-25 |