| NPI | 1538471461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1300X Pharmacist, Psychiatric (Licence: PA RP444601) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP444601) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2022-07-06 |