| NPI | 1083023147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 81515) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 35665) |
| Enumeration Date | 2014-08-03 |
| Last Update Date | 2020-07-30 |