| NPI | 1700060126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 55008) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 048044) |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2023-01-28 |