| NPI | 1578390704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 55849) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 32218) |
| Enumeration Date | 2024-09-19 |
| Last Update Date | 2024-09-19 |