| NPI | 1205034782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 61925) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 14671-040) |
| 183500000X Pharmacist (Licence: CA 61925) | |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2016-09-19 |