| NPI | 1194243022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1300X Pharmacist, Psychiatric (Licence: KS 1-16873) |
| Additional Taxonomies | 1835P1300X Pharmacist, Psychiatric (Licence: TX 61700) |
| 1835P1300X Pharmacist, Psychiatric (Licence: HI PH4043) | |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2020-11-27 |