| NPI | 1639734460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 10536) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 64173) |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2019-06-11 |