| NPI | 1710972500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR 8514) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 17707) |
| 183500000X Pharmacist (Licence: WA 60028510) | |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OR 8514) | |
| Enumeration Date | 2005-09-17 |
| Last Update Date | 2016-03-13 |