| NPI | 1619281706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 55447) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ 14618) |
| Enumeration Date | 2010-07-30 |
| Last Update Date | 2010-07-30 |