| NPI | 1841612231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH 39648) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 09181) |
| Enumeration Date | 2014-01-20 |
| Last Update Date | 2014-01-20 |