| NPI | 1942538962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 47230) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM 7148) |
| 1835N0905X Pharmacist, Nuclear (Licence: NM 7148) | |
| 1835N0905X Pharmacist, Nuclear (Licence: TX 47230) | |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2009-12-02 |