| NPI | 1285196576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH82085) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA INT36040) |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2020-02-16 |