| NPI | 1225380371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH 47901) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 13947) |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2012-10-12 |