| NPI | 1750304531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 28428) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 8323) |
| 183500000X Pharmacist (Licence: NV 16153) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2025-11-27 |