| NPI | 1952742090 |
|---|---|
| Former Name | NA NA NA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TX 53976) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA CA60982) |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2014-11-07 |