| NPI | 1184231961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 50391) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 8782) |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2020-09-25 |