| NPI | 1598256364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA 027151) |
| Additional Taxonomies | 1835P1300X Pharmacist, Psychiatric (Licence: GA 4150329) |
| Enumeration Date | 2018-05-28 |
| Last Update Date | 2018-05-28 |