| NPI | 1386865384 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MO 2006026104) |
| Additional Taxonomies | 1835P1300X Pharmacist, Psychiatric (Licence: MO 2006026104) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2007-08-15 |