| NPI | 1508313479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 15150) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP449445) |
| 183500000X Pharmacist (Licence: TN 39037) | |
| 183500000X Pharmacist (Licence: SC 9856) | |
| 183500000X Pharmacist (Licence: FL PS30438) | |
| 183500000X Pharmacist (Licence: NE 14842) | |
| 183500000X Pharmacist (Licence: VA 202208924) | |
| 183500000X Pharmacist (Licence: WV RP0009855) | |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2016-09-08 |