| NPI | 1477118768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 48671) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03938300) |
| 183500000X Pharmacist (Licence: NY 064251) | |
| 183500000X Pharmacist (Licence: LA PST.022736) | |
| 183500000X Pharmacist (Licence: MD 26144) | |
| 183500000X Pharmacist (Licence: MN 123791) | |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2019-05-03 |