| NPI | 1801132584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH 66136) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: HI 2747) |
| Enumeration Date | 2012-12-27 |
| Last Update Date | 2012-12-27 |