| NPI | 1740626191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: PA RP446594) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WV RP0008817) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: PA 3130303) | |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2014-09-19 |