| NPI | 1700326147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 75414) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH233503) |
| Enumeration Date | 2017-03-05 |
| Last Update Date | 2017-03-05 |