NPI | 1194052712 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: TX 40670) |
Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS44473) |
183500000X Pharmacist (Licence: MA 1067119) | |
Enumeration Date | 2009-11-04 |
Last Update Date | 2020-12-31 |