| NPI | 1962873166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 68375) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 13864) |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2015-10-14 |