| NPI | 1043789753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 82441) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 25749) |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2020-10-07 |