| NPI | 1336629419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: TX 63066) |
| Additional Taxonomies | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TX 63066) |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2019-10-01 |