| NPI | 1326685090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 81109) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P8639) |
| Enumeration Date | 2019-12-02 |
| Last Update Date | 2019-12-20 |