| NPI | 1407379340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 75477) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH61017876) |
| 183500000X Pharmacist (Licence: HI 4074) | |
| Enumeration Date | 2017-07-23 |
| Last Update Date | 2023-08-02 |