| NPI | 1871199596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 82954) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR 0018209) |
| Enumeration Date | 2020-12-08 |
| Last Update Date | 2023-06-30 |