| NPI | 1881143501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MN 123062) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302040895) |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2022-09-01 |