| NPI | 1780253088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH89165) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH240137) |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2026-03-03 |