| NPI | 1245737378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 78051) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO PHA.0021397) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2022-05-10 |