NPI | 1255625042 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH232605) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NH 3652) |
Enumeration Date | 2011-06-08 |
Last Update Date | 2011-06-08 |