| NPI | 1376545095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: PA RP039473R) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202205165) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: DC PH100000586) | |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2011-12-16 |