| NPI | 1174602510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 39554) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: HI 1945) |
| 183500000X Pharmacist (Licence: NV 9014) | |
| Enumeration Date | 2006-11-05 |
| Last Update Date | 2016-04-17 |