| NPI | 1093388746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL ps27190) |
| Additional Taxonomies | 1835P1300X Pharmacist, Psychiatric (Licence: FL PS27190) |
| Enumeration Date | 2021-07-21 |
| Last Update Date | 2021-07-21 |