| NPI | 1053963504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH78270) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR PD14169) |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2019-07-15 |