| NPI | 1457823155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 77539) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 77539) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 7539) | |
| 1835P1300X Pharmacist, Psychiatric (Licence: CA 77539) | |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: CA 77539) | |
| Enumeration Date | 2018-12-19 |
| Last Update Date | 2022-10-24 |