| NPI | 1518234517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA rph 59622) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03-01-22474) |
| Enumeration Date | 2011-11-19 |
| Last Update Date | 2011-11-19 |