| NPI | 1144553520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH76397) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 44552) |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2022-08-17 |