| NPI | 1881022002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 46186) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 29289) |
| Enumeration Date | 2013-10-25 |
| Last Update Date | 2013-10-25 |