| NPI | 1568570992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH41787) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC 9572) |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2010-04-20 |