| NPI | 1548735871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 19732) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NC 19732) |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: NC 19732) | |
| Enumeration Date | 2018-10-13 |
| Last Update Date | 2018-10-13 |