| NPI | 1902093552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 47038) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: CA 47038) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 47038) | |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2007-09-27 |