NPI | 1639453343 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: TX 48073) |
Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60095982) |
183500000X Pharmacist (Licence: AZ S017751) | |
Enumeration Date | 2011-09-30 |
Last Update Date | 2011-09-30 |