NPI | 1255617387 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: NE 11548) |
Additional Taxonomies | 183500000X Pharmacist (Licence: MN 112174) |
183500000X Pharmacist (Licence: IA 19243) | |
Enumeration Date | 2011-11-03 |
Last Update Date | 2011-11-03 |