NPI | 1063748796 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: TX 46615) |
Additional Taxonomies | 183500000X Pharmacist (Licence: OK 14307) |
Enumeration Date | 2009-10-31 |
Last Update Date | 2019-05-17 |