| NPI | 1437412517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 47978) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 153757-1701) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2012-06-22 |