| NPI | 1417406828 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1835P0200X Pharmacist, Pediatrics (Licence: CA 65954)  | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 65954)  | 
| 1835C0205X Pharmacist, Critical Care (Licence: CA 65954)  | |
| Enumeration Date | 2016-09-27 | 
| Last Update Date | 2016-10-11 |