| NPI | 1942658463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 68908) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS 48095) |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2016-05-25 |