NPI | 1083240048 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: CA 64451) |
Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA 64451) |
3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: 64451) | |
Enumeration Date | 2020-03-20 |
Last Update Date | 2020-03-20 |