| NPI | 1508240466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 73110) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 8031872-1701) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2015-08-28 |