| NPI | 1932705886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 17414) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 65069) |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2020-12-07 |