NPI | 1649870148 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2017044638) |
Additional Taxonomies | 183500000X Pharmacist (Licence: SD 5667) |
183500000X Pharmacist (Licence: MN 122425) | |
183500000X Pharmacist (Licence: IA 23217) | |
Enumeration Date | 2020-10-26 |
Last Update Date | 2020-10-26 |