| NPI | 1801290531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 78123) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 18689) |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2023-02-21 |