| NPI | 1740276195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH38728) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA PHY43751) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2017-07-18 |