| NPI | 1073681748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835N0905X Pharmacist, Nuclear (Licence: NC 17676) |
| Additional Taxonomies | 1835N0905X Pharmacist, Nuclear (Licence: AL 15269) |
| 1835N0905X Pharmacist, Nuclear (Licence: GA RPH023139) | |
| 1835N0905X Pharmacist, Nuclear (Licence: SC 11518) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2010-03-23 |