| NPI | 1407425937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TX 64090) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 64090) |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: TX 64090) | |
| Enumeration Date | 2021-06-19 |
| Last Update Date | 2021-06-19 |