| NPI | 1811613458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH90129) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P10322) |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2024-09-06 |