| NPI | 1194001214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NE 13753) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 13753) |
| Enumeration Date | 2011-11-02 |
| Last Update Date | 2013-03-07 |