NPI | 1184965873 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A159614) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NY 057714) |
Enumeration Date | 2013-03-06 |
Last Update Date | 2023-07-28 |