| NPI | 1316350770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 64410) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: DC 3131996) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2014-06-03 |