| NPI | 1518022474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1300X Pharmacist, Psychiatric (Licence: AZ 13320) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 70685) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2016-01-13 |