| NPI | 1336531284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV RPh 17086) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPh 59403) |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2025-02-03 |