| NPI | 1831335215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR 8305) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 44488) |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2014-06-13 |