| NPI | 1447290366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH46669) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 11721) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2007-07-08 |