| NPI | 1972103372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: UT 5855623-1701) |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |