| NPI | 1962740639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S020050) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH61012565) |
| 183500000X Pharmacist (Licence: GA RPH032634) | |
| 183500000X Pharmacist (Licence: WI 16782-40) | |
| 183500000X Pharmacist (Licence: CA 68510) | |
| 183500000X Pharmacist (Licence: OR RPH-0016548) | |
| 183500000X Pharmacist (Licence: IL 051.303205) | |
| 183500000X Pharmacist (Licence: TX 66552) | |
| 183500000X Pharmacist (Licence: NV 20420) | |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2021-11-17 |