| NPI | 1487924916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TN 34541) |
| Additional Taxonomies | 1835N1003X Pharmacist, Nutrition Support (Licence: MS E-7450) |
| Enumeration Date | 2011-12-30 |
| Last Update Date | 2011-12-30 |