| NPI | 1912397381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 64884) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 3131744) |
| Enumeration Date | 2015-01-23 |
| Last Update Date | 2021-11-26 |