| NPI | 1528187630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 25141) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 3996) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2015-03-30 |