| NPI | 1104290907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TX 52064) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 52064) |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2022-03-15 |