| NPI | 1518470731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MD 25588) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202215966) |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2019-05-07 |