| NPI | 1619399771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM RP00005383) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH 46073) |
| Enumeration Date | 2014-01-09 |
| Last Update Date | 2014-01-09 |