| NPI | 1245648757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 72617) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S020701) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2015-10-23 |