| NPI | 1891000469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 48049) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 12543) |
| Enumeration Date | 2010-08-08 |
| Last Update Date | 2010-08-08 |