| NPI | 1922555291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 72336) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA ph235026) |
| Enumeration Date | 2016-09-05 |
| Last Update Date | 2024-02-17 |