| NPI | 1952680969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CO PHA-17844) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: GA RPH023639) |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2011-08-08 |