| NPI | 1104843929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist Geriatric (Licence: AZ S011242) |
| Additional Taxonomies | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: AZ S011242) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2009-07-02 |