| NPI | 1932879095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH238485) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH82592) |
| 1835G0303X Pharmacist, Geriatric (Licence: MA 99108572) | |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2021-09-20 |