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Individual
VY BUI
Active
Individual
VY BUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6723965-1701
UT
Other
Enumeration date
08/25/2020
Last updated
08/25/2020
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