| NPI | 1831611102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1300X Pharmacist, Psychiatric (Licence: AZ 4151106) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S023236) |
| 183500000X Pharmacist (Licence: OR 00154155) | |
| Enumeration Date | 2017-07-08 |
| Last Update Date | 2025-08-06 |