| NPI | 1700056603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH40968) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: CA RPH40968) |
| 1835P1300X Pharmacist, Psychiatric (Licence: CA RPH40968) | |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2008-03-06 |