| NPI | 1780664276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA rph 54795) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV rph 14692) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2007-07-08 |