NPI | 1063927598 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: NY 063726) |
Additional Taxonomies | 183500000X Pharmacist (Licence: VT 033.0104233) |
Enumeration Date | 2017-12-06 |
Last Update Date | 2017-12-06 |