| NPI | 1831471549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 17215) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 31066) |
| 183500000X Pharmacist (Licence: UT 7296658-1701) | |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2011-09-20 |