NPI | 1700974482 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: CA 55191) |
Additional Taxonomies | 1835N1003X Pharmacist, Nutrition Support (Licence: CA 55191) |
Enumeration Date | 2006-10-10 |
Last Update Date | 2007-07-08 |