| NPI | 1174315105 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: VA 0202222767) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202222767) |
| Enumeration Date | 2025-05-17 |
| Last Update Date | 2025-08-11 |