| NPI | 1366439135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 49934) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: PA 040170L) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2013-08-26 |