| NPI | 1447440136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 65018) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 501088-1701) |
| Enumeration Date | 2007-07-28 |
| Last Update Date | 2013-09-20 |