| NPI | 1427335603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 7113517-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 66339) |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2019-04-24 |