| NPI | 1164909271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835C0205X Pharmacist, Critical Care (Licence: CA 77779) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60753130) |
| 183500000X Pharmacist (Licence: HI PH4217) | |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2018-07-20 |