| NPI | 1659516854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WY 3166) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WY 3166) |
| 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician (Licence: WY 53D2181741) | |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2020-12-10 |