| NPI | 1609328178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH238029) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 75620) |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2018-07-23 |