| NPI | 1154489136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 10941) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 202012069) |
| 183500000X Pharmacist (Licence: ME PR4864) | |
| 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NV 17250) | |
| 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CO 17892) | |
| 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NC 19460) | |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2008-05-10 |