| NPI | 1336164854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 0000019781) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26013834A) |
| 183500000X Pharmacist (Licence: OH 03-1-26039) | |
| 183500000X Pharmacist (Licence: KY 013079) | |
| 183500000X Pharmacist (Licence: CO 17188) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2011-11-15 |