| NPI | 1023865755 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WI 21435)  | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 21435)  | 
| Enumeration Date | 2024-05-01 | 
| Last Update Date | 2024-05-01 |