| NPI | 1740456110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH023329) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH 65113) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2011-02-28 |