| NPI | 1740412394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: VT 3509) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VT 033-0003509) |
| 183500000X Pharmacist (Licence: NH 3251) | |
| 2865M2000X Military Hospital, Military General Acute Care Hospital | |
| Enumeration Date | 2009-08-17 |
| Last Update Date | 2016-06-22 |