| NPI | 1386682813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 37965) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 37965) |
| 183500000X Pharmacist (Licence: NV 08653) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2011-09-15 |