| NPI | 1235542341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 68636) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP446005) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2014-06-05 |