NPI | 1457638488 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: MO 044787) |
Additional Taxonomies | 183500000X Pharmacist (Licence: TX 39738) |
183500000X Pharmacist (Licence: NM RP00006467) | |
183500000X Pharmacist (Licence: IA 16641) | |
183500000X Pharmacist (Licence: KS 1-12695) | |
Enumeration Date | 2011-11-04 |
Last Update Date | 2011-11-04 |