| NPI | 1487870507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: DE A1-0004116) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03079300) |
| 183500000X Pharmacist (Licence: PA RP441366) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2015-10-13 |