| NPI | 1790196855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 67340) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: IN 26023576A) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2014-05-12 |