| NPI | 1578374153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 89304) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 237153) |
| Enumeration Date | 2025-01-14 |
| Last Update Date | 2025-01-14 |