| NPI | 1316352255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MD 20794) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 20794) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2019-06-10 |