| NPI | 1871826727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 72557) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS45308) |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2016-03-25 |