NPI | 1669655379 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: NY 050446) |
Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60185111) |
183500000X Pharmacist (Licence: OR 0013421) | |
Enumeration Date | 2007-12-17 |
Last Update Date | 2016-10-05 |