NPI | 1154606358 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: TX 56537) |
Additional Taxonomies | 183500000X Pharmacist (Licence: LA 19512) |
Enumeration Date | 2011-10-19 |
Last Update Date | 2021-11-09 |