NPI | 1811489677 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: IA 21536) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NE 12330) |
Enumeration Date | 2018-06-06 |
Last Update Date | 2020-03-06 |