| NPI | 1558975276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 84180) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P9028) |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2021-03-24 |