| NPI | 1447019138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835E0208X Pharmacist, Emergency Medicine (Licence: CA 78704) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 78704) |
| Enumeration Date | 2024-03-15 |
| Last Update Date | 2024-03-15 |