NPI | 1164792594 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: ME 4237) |
Additional Taxonomies | 183500000X Pharmacist (Licence: VT 0330003780) |
183500000X Pharmacist (Licence: NH R2153) | |
183500000X Pharmacist (Licence: MA PH22593) | |
Enumeration Date | 2012-01-02 |
Last Update Date | 2012-01-02 |