| NPI | 1831526144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR 9380) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 30031) |
| 183500000X Pharmacist (Licence: NV 6793) | |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2013-10-01 |