| NPI | 1790126415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MA PH234612) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH234612) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2026-09-23 |