| NPI | 1770850968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1300X Pharmacist, Psychiatric (Licence: HI PH2707) |
| Additional Taxonomies | 1835X0200X Pharmacist, Oncology (Licence: HI PH2707) |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2015-12-24 |