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Individual
MR. ROBERT MITSUO BABA
Active
Individual
MR. ROBERT MITSUO BABA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0009514
OR
183500000X
Pharmacist
Primary
21616
WA
183500000X
Pharmacist
22060
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009514
PHARMACIST STATE LICENSE
OR
01
—
21616
PHARMACIST STATE LICENSE
WA
Enumeration date
12/04/2006
Last updated
07/08/2007
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