| NPI | 1053625855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: VA 0202209954) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202209954) |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2025-08-21 |