| NPI | 1083991145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 10671) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 38859) |
| 183500000X Pharmacist (Licence: NC 11549) | |
| 183500000X Pharmacist (Licence: UT 5348449-1701) | |
| 183500000X Pharmacist (Licence: FL 12945) | |
| 183500000X Pharmacist (Licence: GA 21726) | |
| 183500000X Pharmacist (Licence: NJ 28RI01332400) | |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2011-11-03 |