NPI | 1376975755 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: CA 69035) |
Additional Taxonomies | 183500000X Pharmacist (Licence: TX 54191) |
Enumeration Date | 2013-08-07 |
Last Update Date | 2016-10-29 |