| NPI | 1982411286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TX 66063) |
| Additional Taxonomies | 1835E0208X Pharmacist, Emergency Medicine (Licence: TX 66063) |
| Enumeration Date | 2024-12-11 |
| Last Update Date | 2025-12-24 |