| NPI | 1114209012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: UT 7114777-1701) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2026-05-08 |