| NPI | 1982119152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 20145) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 77076) |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2020-12-01 |