| NPI | 1619970142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH35514) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps27398) |
| 183500000X Pharmacist (Licence: NV 7775) | |
| Enumeration Date | 2005-05-30 |
| Last Update Date | 2008-12-11 |