NPI | 1073729547 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1835P1300X Pharmacist, Psychiatric (Licence: CA 58923) |
Additional Taxonomies | 183500000X Pharmacist (Licence: CA 58923) |
Enumeration Date | 2007-05-14 |
Last Update Date | 2013-07-05 |