| NPI | 1508293127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 19969) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 60541) |
| 183500000X Pharmacist (Licence: PA 441824) | |
| Enumeration Date | 2013-09-27 |
| Last Update Date | 2013-09-27 |