| NPI | 1629327036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 12394) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 14529) |
| 183500000X Pharmacist (Licence: NC 22399) | |
| 183500000X Pharmacist (Licence: OH 03-2-15276) | |
| 183500000X Pharmacist (Licence: NV 15928) | |
| 183500000X Pharmacist (Licence: GA RPH014529) | |
| 183500000X Pharmacist (Licence: CO 16280) | |
| 183500000X Pharmacist (Licence: ME PR5390) | |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2021-01-22 |