| NPI | 1700057635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NV 15654) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 54011) |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2011-11-09 |