| NPI | 1417342213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 74163) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S021013) |
| 183500000X Pharmacist (Licence: OR 0014453) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2017-09-06 |