| NPI | 1720309636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CO 18720) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 15607040) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2012-02-27 |