| NPI | 1386265437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 85434) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 42885) |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2022-05-09 |