| NPI | 1053190603 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 88477) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID 2261177) |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2024-12-24 |