| NPI | 1215455415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA ph00065842) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH81773) |
| 183500000X Pharmacist (Licence: MI 5302042383) | |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2020-06-18 |