| NPI | 1073171658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 82465) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR PI-0013481) |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2024-12-04 |