| NPI | 1922370741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA 17098) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 14599) |
| 183500000X Pharmacist (Licence: TX 42307) | |
| 183500000X Pharmacist (Licence: PA 444496) | |
| 183500000X Pharmacist (Licence: AZ S020997) | |
| 183500000X Pharmacist (Licence: NM RP00008317) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: AZ 3153899) | |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2022-12-16 |