| NPI | 1538298922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 68500) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH 3407) |
| Enumeration Date | 2007-03-03 |
| Last Update Date | 2020-10-02 |