| NPI | 1053442897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH63865) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH00054708) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2014-07-01 |