| NPI | 1699053058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MA PH25553) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MA PH25553) |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2011-08-02 |