NPI | 1477918563 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: UT 55301051701) |
Additional Taxonomies | 183500000X Pharmacist (Licence: UT 55301058911) |
Enumeration Date | 2015-12-16 |
Last Update Date | 2015-12-16 |