NPI | 1720315013 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: AL 15862) |
Additional Taxonomies | 183500000X Pharmacist (Licence: TX 48013) |
Enumeration Date | 2009-11-08 |
Last Update Date | 2011-09-23 |