NPI | 1669658258 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: WI 13756-040) |
Additional Taxonomies | 183500000X Pharmacist (Licence: SC 10008) |
183500000X Pharmacist (Licence: NY 046788) | |
Enumeration Date | 2008-01-14 |
Last Update Date | 2008-01-25 |