| NPI | 1588934319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 60005) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA Rph60005) |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2022-06-17 |