| NPI | 1245773803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 57145) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202206987) |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2016-11-29 |