| NPI | 1033550470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: CA RPH68799) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302035628) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2022-02-18 |