| NPI | 1245547827 |
|---|---|
| Former Name | ANGELA V BROOKS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 6336) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 29226) |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2010-09-02 |