NPI | 1174675300 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: NC 24999) |
Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NC 4123) |
Enumeration Date | 2007-01-17 |
Last Update Date | 2015-08-04 |