| NPI | 1992005490 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR 0010805)  | 
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OR RPH-0010805)  | 
| Enumeration Date | 2010-10-30 | 
| Last Update Date | 2016-02-26 |