NPI | 1912140609 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: MN 118859) |
Additional Taxonomies | 183500000X Pharmacist (Licence: ND 5120) |
Enumeration Date | 2009-04-11 |
Last Update Date | 2009-04-11 |