| NPI | 1588997282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 62228) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302033296) |
| Enumeration Date | 2009-09-12 |
| Last Update Date | 2023-07-11 |