| NPI | 1265584791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL 20125) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 12646) |
| 183500000X Pharmacist (Licence: AR PD08997) | |
| 183500000X Pharmacist (Licence: MI 5302033233) | |
| 183500000X Pharmacist (Licence: LA 17435) | |
| 183500000X Pharmacist (Licence: NE 12123) | |
| 183500000X Pharmacist (Licence: TN 11362) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2007-07-08 |