| NPI | 1649271586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 48443) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: CA 48443) |
| 1835P1300X Pharmacist Psychiatric (Licence: CA 48443) | |
| 1835G0303X Pharmacist Geriatric (Licence: CA 1296) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2007-07-08 |