| NPI | 1063759926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PHA. 00019677) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH 66693) |
| Enumeration Date | 2013-01-12 |
| Last Update Date | 2013-01-12 |