| NPI | 1295402691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 20918) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 86227) |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2023-02-17 |