| NPI | 1457708844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: MA PH236953) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MA PI158805) |
| 183500000X Pharmacist (Licence: MA PI158805) | |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2022-07-21 |