| NPI | 1962831453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: GA 021591) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302032123) |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2026-05-29 |