NPI | 1689109449 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: MA 236942) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NY 061160) |
Enumeration Date | 2017-04-28 |
Last Update Date | 2021-03-24 |