| NPI | 1083855019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH 38072) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 113402) |
| Enumeration Date | 2009-03-21 |
| Last Update Date | 2009-03-21 |