| NPI | 1629353693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OR 0012289) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR 0012289) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2015-12-21 |