| NPI | 1003229337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH022425) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH48613) |
| 183500000X Pharmacist (Licence: NV 12832) | |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-06-04 |