| NPI | 1255606026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA 15243) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS 12258) |
| 183500000X Pharmacist (Licence: SC 10088) | |
| 183500000X Pharmacist (Licence: NC 11975) | |
| 1835N0905X Pharmacist, Nuclear (Licence: LA 15243) | |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2018-06-14 |