| NPI | 1255643524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH 74850) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH025839) |
| 183500000X Pharmacist (Licence: NY 054396) | |
| 183500000X Pharmacist (Licence: MI 5302037201) | |
| 183500000X Pharmacist (Licence: IL 51294043) | |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2022-11-30 |