| NPI | 1952630196 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 9549)  | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 12242)  | 
| 183500000X Pharmacist (Licence: TN 32473)  | |
| 183500000X Pharmacist (Licence: KY 14224)  | |
| 183500000X Pharmacist (Licence: VA 0202208743)  | |
| 183500000X Pharmacist (Licence: LA 18718)  | |
| 183500000X Pharmacist (Licence: AR PD11042)  | |
| 183500000X Pharmacist (Licence: OR RPH-0011870)  | |
| Enumeration Date | 2009-12-17 | 
| Last Update Date | 2009-12-17 |