NPI | 1235437005 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: MD 17809) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NC 18135) |
Enumeration Date | 2011-03-03 |
Last Update Date | 2024-03-13 |