| NPI | 1487051041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH70686) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS68166) |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2025-02-06 |