| NPI | 1982018487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA RPH27353) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 05717) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2014-06-12 |