| NPI | 1063854347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 69801) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302039675) |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 69801) | |
| Enumeration Date | 2013-07-26 |
| Last Update Date | 2018-01-16 |