| NPI | 1659985471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835N1003X Pharmacist, Nutrition Support (Licence: CA RPH64889) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH64889) |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2022-06-02 |