NPI | 1710242920 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03130070) |
Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302410772) |
Enumeration Date | 2012-07-13 |
Last Update Date | 2012-07-13 |