NPI | 1033122452 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: UT 6038323-1701) |
Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: UT 6038323-1701) |
1835P1200X Pharmacist, Pharmacotherapy (Licence: AZ 7648) | |
1835P1200X Pharmacist, Pharmacotherapy (Licence: NE 9181) | |
Enumeration Date | 2006-08-15 |
Last Update Date | 2007-07-08 |