| NPI | 1477804581 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR 0013294) | 
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OR 0013294) | 
| Enumeration Date | 2012-09-28 | 
| Last Update Date | 2016-12-16 |