| NPI | 1790178788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA rph45628) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 11847) |
| Enumeration Date | 2015-03-15 |
| Last Update Date | 2015-03-15 |