| NPI | 1700131612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 52305) |
| Additional Taxonomies | 1835N1003X Pharmacist, Nutrition Support (Licence: TX 52305) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: TX 52305) | |
| 1835G0303X Pharmacist, Geriatric (Licence: TX 52305) | |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TX 52305) | |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2025-11-03 |