| NPI | 1053581918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH 41546) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 09496) |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2008-03-06 |