| NPI | 1366725616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 76756) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2008028102) |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2017-11-16 |