| NPI | 1386764934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH 54484) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH00053747) |
| 183500000X Pharmacist (Licence: CO PHA - 15953) | |
| 183500000X Pharmacist (Licence: HI PH - 2208) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2015-05-04 |