| NPI | 1205382009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TX 63434) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: LA pst.021712) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2019-05-10 |