| NPI | 1801320817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MN 121180) |
| Additional Taxonomies | 1835P1300X Pharmacist, Psychiatric (Licence: MN 121180) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2017-04-17 |