NPI | 1780800557 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2005036831) |
Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202004177) |
183500000X Pharmacist (Licence: IL 051.027875) | |
Enumeration Date | 2007-04-18 |
Last Update Date | 2007-07-08 |