NPI | 1083100374 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: TX 59784) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NM 8693) |
Enumeration Date | 2018-07-10 |
Last Update Date | 2018-07-10 |