| NPI | 1396253878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH76513) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 122675) |
| 183500000X Pharmacist (Licence: TX 60202) | |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2022-02-14 |