| NPI | 1538316070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 48253) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 61290) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2020-12-09 |