| NPI | 1295841120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: SC 13491) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: FL PS40135) |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: SC 1391) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2018-03-01 |