| NPI | 1063891737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 56244) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 41093) |
| 183500000X Pharmacist (Licence: MD 16820) | |
| 183500000X Pharmacist (Licence: AZ s013200) | |
| 183500000X Pharmacist (Licence: WA 00048345) | |
| 183500000X Pharmacist (Licence: MA ph25473) | |
| 183500000X Pharmacist (Licence: OR 0010753) | |
| 183500000X Pharmacist (Licence: IL 051289096) | |
| 183500000X Pharmacist (Licence: FL PS38051) | |
| 183500000X Pharmacist (Licence: RI RPH04250) | |
| 183500000X Pharmacist (Licence: NV 16889) | |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2015-05-27 |