| NPI | 1982854220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR rph-0009612) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 52223) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2008-09-23 |