NPI | 1992708812 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: FL pu5796) |
Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS37977) |
Enumeration Date | 2005-05-24 |
Last Update Date | 2010-11-10 |