NPI | 1518256593 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202208319) |
Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0005749) |
183500000X Pharmacist (Licence: OH 03-3-23990) | |
Enumeration Date | 2011-03-30 |
Last Update Date | 2011-03-30 |