| NPI | 1922626563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 61179) |
| Additional Taxonomies | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TX 61179) |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2020-07-13 |