| NPI | 1568992972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA 237301) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 76407) |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2017-06-18 |