| NPI | 1326098872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1300X Pharmacist, Psychiatric (Licence: MN 119660) |
| Additional Taxonomies | 1835P1300X Pharmacist, Psychiatric (Licence: WI 15482-40) |
| 1835P1300X Pharmacist, Psychiatric (Licence: IN 26015952A) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2017-03-28 |