| NPI | 1881498491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 90782) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202220648) |
| Enumeration Date | 2025-04-02 |
| Last Update Date | 2026-05-24 |