| NPI | 1215220959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS 53989) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH49067) |
| 183500000X Pharmacist (Licence: PA RP038578T) | |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2016-03-03 |