NPI | 1639428774 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: NC 22679) |
Additional Taxonomies | 183500000X Pharmacist (Licence: SC 13807) |
Enumeration Date | 2012-09-05 |
Last Update Date | 2016-08-16 |