NPI | 1902157787 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03136069) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NC 22847) |
183500000X Pharmacist (Licence: NY 059576) | |
Enumeration Date | 2012-09-20 |
Last Update Date | 2020-04-16 |