| NPI | 1245534452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 61138) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 27408) |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2012-10-11 |