| NPI | 1356831168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 62210) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S014243) |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2018-05-16 |