| NPI | 1619482932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MI 5302412279) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03236757) |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2020-01-20 |