| NPI | 1801105135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3336I0012X Pharmacy, Institutional Pharmacy (Licence: CA LCF57082) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 64699) |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2020-01-15 |