| NPI | 1386098085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 8089467) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 72218) |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2016-04-19 |