| NPI | 1578709820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 63651) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP441871) |
| Enumeration Date | 2008-12-16 |
| Last Update Date | 2014-05-14 |