| NPI | 1760554687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 34115) |
| Additional Taxonomies | 1835P2201X Pharmacist Ambulatory Care (Licence: TX 34115) |
| 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TX 34115) | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2025-06-01 |