| NPI | 1790128676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OR 14000) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 19730) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2017-04-26 |