| NPI | 1750648473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 31287) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 07099) |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2012-04-19 |