| NPI | 1669726238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 59318) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 054727) |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2014-04-24 |