NPI | 1649563693 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: NC 18086) |
Additional Taxonomies | 183500000X Pharmacist (Licence: MA 25654) |
Enumeration Date | 2011-05-24 |
Last Update Date | 2011-05-24 |