| NPI | 1043790561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: CA 77552) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 77552) |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2020-01-05 |