NPI | 1114335668 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: NC 25671) |
Additional Taxonomies | 183500000X Pharmacist (Licence: GA 024534) |
183500000X Pharmacist (Licence: SC 035410) | |
Enumeration Date | 2014-07-29 |
Last Update Date | 2015-12-23 |