| NPI | 1548243546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR 0008464) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 32102) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2007-07-08 |