| NPI | 1366852444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1300X Pharmacist Psychiatric (Licence: TN 37525) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 37525) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2018-03-17 |