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Individual
BRADEN JEFFREY ENFIELD
Active
Individual
BRADEN JEFFREY ENFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0017381
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH-0017381
STATE RPH LICENSE
OR
Enumeration date
08/16/2019
Last updated
08/16/2019
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