| NPI | 1922381938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: CA 69006) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VT 033.0078218) |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2024-04-26 |