| NPI | 1902489321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH82373) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 82373) |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2024-07-28 |