| NPI | 1619985983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: WI 14347-040) |
| Additional Taxonomies | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WI 14347-40) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2012-08-30 |