| NPI | 1740231125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1300X Pharmacist, Psychiatric (Licence: MA 23302) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 23302) |
| 1835N1003X Pharmacist, Nutrition Support (Licence: MA 23302) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: MA 23302) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2025-09-11 |