NPI | 1285048512 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03135964) |
Additional Taxonomies | 183500000X Pharmacist (Licence: KY 017066) |
Enumeration Date | 2014-06-14 |
Last Update Date | 2020-10-03 |