| NPI | 1952625923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA RPH31194) |
| Additional Taxonomies | 1835P1300X Pharmacist, Psychiatric (Licence: CA RPH31194) |
| Enumeration Date | 2010-03-19 |
| Last Update Date | 2010-03-19 |