| NPI | 1689838153 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MA PH27571) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT PCT.00110074) |
| 1835G0303X Pharmacist, Geriatric (Licence: MA PH27571) | |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2014-12-01 |