| NPI | 1700116779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 70464) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S12606) |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2014-09-02 |