NPI | 1104195890 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: NE 13437) |
Additional Taxonomies | 183500000X Pharmacist (Licence: IA 21289) |
Enumeration Date | 2011-12-24 |
Last Update Date | 2011-12-24 |