| NPI | 1912366261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 73915) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S020781) |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2016-02-15 |