NPI | 1215017058 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: CA 33405) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NV 07881) |
Enumeration Date | 2006-10-16 |
Last Update Date | 2007-07-08 |