NPI | 1215371463 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: OR 0013977) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NY 055190) |
183500000X Pharmacist (Licence: OH 03-3-29033-3) | |
183500000X Pharmacist (Licence: IL 051-292451) | |
Enumeration Date | 2013-04-18 |
Last Update Date | 2014-03-19 |