| NPI | 1972134294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 80993) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 80993) |
| 1835P1300X Pharmacist, Psychiatric (Licence: CA 80993) | |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: CA 80993) | |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2021-12-14 |