| NPI | 1023315900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1300X Pharmacist, Psychiatric (Licence: FL PS44803) |
| Additional Taxonomies | 1835P1300X Pharmacist, Psychiatric (Licence: NJ 28RI0326300) |
| Enumeration Date | 2011-02-11 |
| Last Update Date | 2017-12-14 |