| NPI | 1306397245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 74533) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S021162) |
| Enumeration Date | 2016-10-15 |
| Last Update Date | 2016-10-15 |