NPI | 1134414758 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: TX 56467) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NY 051446-1) |
Enumeration Date | 2011-06-11 |
Last Update Date | 2020-01-28 |