| NPI | 1326207432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS 34909) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202217069) |
| 183500000X Pharmacist (Licence: KY 019828) | |
| 183500000X Pharmacist (Licence: TX 62247) | |
| 183500000X Pharmacist (Licence: AR PD14374) | |
| 183500000X Pharmacist (Licence: NC 27644) | |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2018-11-14 |