| NPI | 1255794822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NE 13748) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 13366) |
| 183500000X Pharmacist (Licence: NV 18489) | |
| 183500000X Pharmacist (Licence: MN 121145) | |
| 183500000X Pharmacist (Licence: KS 1-15582) | |
| 183500000X Pharmacist (Licence: CO 20182) | |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2016-03-31 |