| NPI | 1255641718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 9775) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 49203) |
| 183500000X Pharmacist (Licence: IN 26013139a) | |
| 183500000X Pharmacist (Licence: CT pct0005692) | |
| 183500000X Pharmacist (Licence: NC 17522) | |
| 183500000X Pharmacist (Licence: GA rph021123) | |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2013-10-09 |