NPI | 1508242918 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: MA PH236081) |
Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH236081) |
Enumeration Date | 2015-08-07 |
Last Update Date | 2023-05-16 |