| NPI | 1093170797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 74342) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 25739) |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2017-09-25 |