| NPI | 1174154298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH51976) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RPH045145L) |
| Enumeration Date | 2020-01-28 |
| Last Update Date | 2020-01-28 |