| NPI | 1528334000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: CA RPH63781) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: FL PS45121) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2015-04-27 |