| NPI | 1710159041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: AZ S05652) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH 28508) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2008-03-27 |