NPI | 1548562168 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: NC 18721) |
Additional Taxonomies | 183500000X Pharmacist (Licence: TX 22766) |
183500000X Pharmacist (Licence: NM 3993) | |
183500000X Pharmacist (Licence: SC 11723) | |
Enumeration Date | 2010-12-02 |
Last Update Date | 2010-12-02 |