| NPI | 1952666208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS48759) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03480300) |
| 183500000X Pharmacist (Licence: GA RPH027432) | |
| 183500000X Pharmacist (Licence: TX 51230) | |
| 183500000X Pharmacist (Licence: VA 0202212550) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: FL 3155664) | |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: FL 6151587) | |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2020-06-06 |