| NPI | 1316399199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1300X Pharmacist, Psychiatric (Licence: NC 26200) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 26200) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2023-05-26 |