| NPI | 1073878112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 70894) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 70894) |
| Enumeration Date | 2012-07-04 |
| Last Update Date | 2021-11-30 |