| NPI | 1922611961 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: UT 6358877-1701)  | 
| Enumeration Date | 2020-08-28 | 
| Last Update Date | 2020-08-28 |