| NPI | 1275260754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 89856) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P10187) |
| Enumeration Date | 2022-08-04 |
| Last Update Date | 2024-08-23 |