| NPI | 1760947253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA C477847) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA C47887) |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2019-02-08 |