| NPI | 1801034525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH 36419) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 8274) |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2009-02-03 |