NPI | 1083617575 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: NY 046926) |
Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS34495) |
183500000X Pharmacist (Licence: CA 61098) | |
Enumeration Date | 2005-05-27 |
Last Update Date | 2010-03-22 |