| NPI | 1356347330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NE 11779) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 11779) |
| 1835P1300X Pharmacist, Psychiatric (Licence: NE 11779) | |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TX 44923) | |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2009-12-14 |