NPI | 1871153874 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: CA 77902) |
Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS55807) |
Enumeration Date | 2019-06-20 |
Last Update Date | 2022-07-29 |