| NPI | 1629432786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 5101025473) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5101025473) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2020-04-06 |