| NPI | 1487065629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 78542) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM IN00003767) |
| Enumeration Date | 2014-05-09 |
| Last Update Date | 2024-04-09 |