| NPI | 1629520556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NC 3151003) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302039941) |
| 183500000X Pharmacist (Licence: NC 25376) | |
| 183500000X Pharmacist (Licence: PA RP451080) | |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2016-10-26 |