| NPI | 1205027455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: NC 18856) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NC 0070-00231) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2012-11-13 |