| NPI | 1205448743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA 70071837) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03444576) |
| 183500000X Pharmacist (Licence: AL 22587) | |
| 183500000X Pharmacist (Licence: SC 43104) | |
| 183500000X Pharmacist (Licence: IL 051.305063) | |
| 183500000X Pharmacist (Licence: FL PS60698) | |
| 183500000X Pharmacist (Licence: GA RPH030722) | |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2026-07-09 |