| NPI | 1699066290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH63791) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ME PR5681) |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2011-04-29 |