| NPI | 1710275326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 74509) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 058673) |
| Enumeration Date | 2011-07-17 |
| Last Update Date | 2021-02-23 |