| NPI | 1457909228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH88974) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: CA TCH169758) |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2023-11-25 |