| NPI | 1639545056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MA ph236131) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH236131) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2025-07-30 |