NPI | 1619347994 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MI 5302035707) |
Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NC 24956) |
1835P1200X Pharmacist, Pharmacotherapy (Licence: HI PH-3076) | |
Enumeration Date | 2015-09-30 |
Last Update Date | 2015-09-30 |