| NPI | 1588321897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 84475) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS61927) |
| Enumeration Date | 2021-11-22 |
| Last Update Date | 2022-03-09 |