| NPI | 1881638534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 28050) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302033222) |
| 183500000X Pharmacist (Licence: AR PD09056) | |
| 183500000X Pharmacist (Licence: NE 12224) | |
| 183500000X Pharmacist (Licence: LA 17564) | |
| 183500000X Pharmacist (Licence: KY 013146) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2017-02-20 |