| NPI | 1598779365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: FL PS61714) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03-2-18193) |
| 183500000X Pharmacist (Licence: MI 5302026406) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2025-08-08 |