| NPI | 1477873602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 46256) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 11605) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2010-06-10 |