| NPI | 1972102846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: KY 021314) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2020043219) |
| Enumeration Date | 2020-10-22 |
| Last Update Date | 2023-11-14 |