| NPI | 1093043721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1300X Pharmacist, Psychiatric (Licence: ID P6698) |
| Additional Taxonomies | 1835P1300X Pharmacist, Psychiatric (Licence: UT 7297906-1701) |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2019-05-08 |