| NPI | 1235111345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NM PC97) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM PC00000097) |
| 1835N1003X Pharmacist, Nutrition Support (Licence: NM PC97 PRH6595) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: NM RP00006595) | |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2014-05-21 |