| NPI | 1922392802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WV RP0008414) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 183500000X Pharmacist (Licence: WV RP0008414) | |
| 183500000X Pharmacist (Licence: NC 23996) | |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NC 23996) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: WV RP0008414) | |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2014-09-29 |