NPI | 1154324556 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: MA 19489) |
Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP035829R) |
Enumeration Date | 2005-05-31 |
Last Update Date | 2013-04-11 |