| NPI | 1255984233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1300X Pharmacist Psychiatric (Licence: MI 5302411660) |
| Additional Taxonomies | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MI 5302411660) |
| Enumeration Date | 2019-07-19 |
| Last Update Date | 2020-09-16 |