| NPI | 1497371082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302412169) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH84230) |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2026-05-07 |