| NPI | 1801266234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR 8099) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 44120) |
| Enumeration Date | 2015-09-28 |
| Last Update Date | 2015-09-28 |