NPI | 1740552835 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: MA PH232796) |
Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH232796) |
Enumeration Date | 2012-02-03 |
Last Update Date | 2018-12-26 |