| NPI | 1235122987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH022052) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH52855) |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2007-07-08 |