| NPI | 1730662180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 83806) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 19572-40) |
| 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: FL 59236) | |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2021-05-05 |