| NPI | 1104860832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TN 0000008221) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 0000008221) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2015-02-25 |