| NPI | 1811990989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 57710) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: VA 0202206302) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2010-10-14 |