| NPI | 1982989554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 118945) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MN 118945) |
| 1835P0200X Pharmacist, Pediatrics (Licence: MN 118945) | |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2022-06-22 |