| NPI | 1558388272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 39696) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: AZ 8318) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2007-07-08 |