| NPI | 1205642592 |
|---|---|
| Other Name | DBA EL DORADO DRUG STORE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY59418) |
| Enumeration Date | 2024-12-10 |
| Last Update Date | 2025-07-22 |