| NPI | 1225438658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 67185) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP00006883) |
| 183500000X Pharmacist (Licence: MD 16118) | |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2014-09-04 |