| NPI | 1528621968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 78317) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0016542) |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2019-04-22 |