| NPI | 1134580061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 74190) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO PHA.0021036) |
| Enumeration Date | 2016-03-20 |
| Last Update Date | 2016-03-20 |