| NPI | 1841334257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 51435) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 12317) |
| Enumeration Date | 2007-02-18 |
| Last Update Date | 2007-07-08 |