NPI | 1790259174 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: NY I061289-1) |
Additional Taxonomies | 183500000X Pharmacist (Licence: CT PCT.0013136) |
183500000X Pharmacist (Licence: NJ 28RI03766100) | |
Enumeration Date | 2019-01-18 |
Last Update Date | 2019-01-18 |