NPI | 1093017014 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: SC 011054) |
Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202204712) |
183500000X Pharmacist (Licence: NC 16770) | |
Enumeration Date | 2010-11-23 |
Last Update Date | 2010-11-23 |