| NPI | 1396253894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH80520) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60781058) |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2021-12-17 |