| NPI | 1790111045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 20493) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202213867) |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NC 20493) | |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2020-01-28 |