NPI | 1124303573 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: NV 18096) |
Additional Taxonomies | 183500000X Pharmacist (Licence: UT 8005979-1701) |
Enumeration Date | 2011-10-18 |
Last Update Date | 2020-10-29 |