| NPI | 1558737379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1300X Pharmacist, Psychiatric (Licence: CA 66295) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 66295) |
| Enumeration Date | 2015-08-16 |
| Last Update Date | 2022-01-10 |