| NPI | 1306890686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MA 25883) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: MA 25883) |
| 1835P2201X Pharmacist Ambulatory Care (Licence: MA 25883) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2016-04-18 |