| NPI | 1164702007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OR 0012762) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR 0012762) |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2016-02-16 |