| NPI | 1275193146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 59684) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH83640) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2025-03-07 |