NPI | 1104190990 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH024513) |
Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS42485) |
183500000X Pharmacist (Licence: TX 46840) | |
Enumeration Date | 2012-02-27 |
Last Update Date | 2012-02-27 |