| NPI | 1790038578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: VA 0202214261) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 057291-1) |
| 183500000X Pharmacist (Licence: NC 22668) | |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: DC PH100002298) | |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MD 23971) | |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2016-08-22 |