| NPI | 1538659636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 44096) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 9874-040) |
| 183500000X Pharmacist (Licence: AZ S007212) | |
| 183500000X Pharmacist (Licence: TX 59699) | |
| 183500000X Pharmacist (Licence: FL PS55787) | |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2018-05-14 |