| NPI | 1578846820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA rph57404) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 51234) |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2025-06-02 |