| NPI | 1831365444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 15858) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 38214) |
| 1835N1003X Pharmacist, Nutrition Support (Licence: NV 15858) | |
| 1835N1003X Pharmacist, Nutrition Support (Licence: CA 38214) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: NV 15858) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 38214) | |
| Enumeration Date | 2008-05-03 |
| Last Update Date | 2009-10-22 |