NPI | 1609061662 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: NM RP00006000) |
Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60188349) |
Enumeration Date | 2007-09-12 |
Last Update Date | 2015-05-19 |