NPI | 1790040863 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: SC 13922) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NC 22700) |
Enumeration Date | 2012-07-05 |
Last Update Date | 2021-10-03 |