| NPI | 1316495435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 78350) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 26419) |
| 183500000X Pharmacist (Licence: SC 36852) | |
| Enumeration Date | 2016-09-18 |
| Last Update Date | 2021-01-07 |