| NPI | 1336315506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 16957) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 35610) |
| 183500000X Pharmacist (Licence: FL PS26360) | |
| 1835N0905X Pharmacist, Nuclear (Licence: NC 16957) | |
| 1835N0905X Pharmacist, Nuclear (Licence: NY 35610) | |
| 1835N0905X Pharmacist, Nuclear (Licence: FL NP147) | |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2008-05-07 |