| NPI | 1013282912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH 25780) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 05078) |
| Enumeration Date | 2012-03-12 |
| Last Update Date | 2012-03-12 |