| NPI | 1992092027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 35247) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 113090) |
| Enumeration Date | 2011-07-10 |
| Last Update Date | 2011-07-10 |