| NPI | 1790148583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 199796) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 199796) |
| 208000000X Pediatrics (Licence: FL ME141288) | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2025-04-16 |