| NPI | 1043720873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 86060) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS57041) |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2022-06-21 |