NPI | 1902136765 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: MD 21265) |
Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP00007261) |
Enumeration Date | 2009-12-30 |
Last Update Date | 2015-10-29 |