| NPI | 1215245774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA rph43715) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: HI ph1333) |
| Enumeration Date | 2010-09-18 |
| Last Update Date | 2010-09-18 |