| NPI | 1407252794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MD 17931) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH00069064) |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OH 03-3-28683) | |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2014-11-13 |