| NPI | 1467166595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 87227) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH240198) |
| Enumeration Date | 2023-01-12 |
| Last Update Date | 2024-02-07 |