NPI | 1902281108 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: AK 104272) |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: MT 25213) |
Enumeration Date | 2015-07-29 |
Last Update Date | 2024-04-01 |