| NPI | 1164496436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WA 00011679) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: NV 11036) |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: CO 13722) | |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: WA 262-0301-11679) | |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: IA T-16175) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2019-03-05 |