| NPI | 1326365255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 69376) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA rph56714) |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2021-10-14 |