| NPI | 1952095135 |
|---|---|
| Other Name | SMOKE 04/04 |
| Other Name | SMOKE 12/12 |
| Other Name | SMOKE 4/30/2024 |
| Other Name | SMOKE 10/29 |
| Doing Business As | TEST DBA |
| Other Name | SMOKE 2/6/2024 |
| Doing Business As | TEST |
| Entity Type | Organization |
| Authorized Contact | TEST ORG-A Admin 555-111-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 1835C0206X Pharmacist, Cardiology |
| 1835C0207X Pharmacist, Compounded Sterile Preparations | |
| 1835E0208X Pharmacist, Emergency Medicine | |
| 1835I0206X Pharmacist, Infectious Diseases | |
| 1835S0206X Pharmacist, Solid Organ Transplant | |
| 207SG0207X Medical Genetics, Medical Biochemical Genetics | |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2024-10-29 |