NPI | 1497756829 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS24321) |
Additional Taxonomies | 1835N1003X Pharmacist, Nutrition Support (Licence: FL PS24321) |
1835P1200X Pharmacist, Pharmacotherapy (Licence: FL PS24321) | |
Enumeration Date | 2005-08-09 |
Last Update Date | 2012-12-28 |