| NPI | 1639234099 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OR 0014100) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 16069) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2018-01-22 |