| NPI | 1992741680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: TN 1101-0132-5393-524) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA EXC 16844) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2007-08-09 |