| NPI | 1821357930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VT 033.0092220) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 66702) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2023-01-18 |