NPI | 1558498071 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: TX 17533) |
Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate (Licence: TX 31094) |
Enumeration Date | 2007-02-28 |
Last Update Date | 2007-10-12 |