| NPI | 1578796942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0011540) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH35649) |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2009-09-01 |