| NPI | 1740723949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH80291) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA PST.021837) |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2021-01-05 |