| NPI | 1619279924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 60748) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS44540) |
| Enumeration Date | 2010-11-19 |
| Last Update Date | 2010-11-19 |