NPI | 1932498557 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: OR 6611) |
Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60060820) |
183500000X Pharmacist (Licence: AZ S017817) | |
183500000X Pharmacist (Licence: TX 24695) | |
Enumeration Date | 2011-04-05 |
Last Update Date | 2011-04-05 |