NPI | 1639627722 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: CA 70207) |
Additional Taxonomies | 183500000X Pharmacist (Licence: TX 35110) |
Enumeration Date | 2016-09-17 |
Last Update Date | 2016-09-17 |