| NPI | 1760710305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 61406) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 24712) |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2009-11-19 |