| NPI | 1326256595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835N0905X Pharmacist, Nuclear (Licence: OR 0012144) |
| Additional Taxonomies | 1835N0905X Pharmacist, Nuclear (Licence: CA 59919) |
| 1835N0905X Pharmacist, Nuclear (Licence: TX 48323) | |
| 1835N0905X Pharmacist, Nuclear (Licence: CO PHA-17938) | |
| 1835N0905X Pharmacist, Nuclear (Licence: PA RP441624) | |
| Enumeration Date | 2007-05-19 |
| Last Update Date | 2019-02-28 |