NPI | 1508282310 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2008021312) |
Additional Taxonomies | 183500000X Pharmacist (Licence: OK 14249) |
183500000X Pharmacist (Licence: KS 1-14812) | |
Enumeration Date | 2014-03-17 |
Last Update Date | 2014-03-17 |