| NPI | 1548969058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 44183) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: CA 50814) |
| Enumeration Date | 2023-02-23 |
| Last Update Date | 2023-04-18 |