| NPI | 1417947557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 57257) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: WA 63460) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2013-07-10 |