| NPI | 1780953638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TX 58222) |
| Additional Taxonomies | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: FL PS48334) |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2017-02-09 |