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Individual
WADIM TIMAKOV
Active
Individual
WADIM TIMAKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PCT.0009785
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PCT.0009785
PHARMACIST LICENSE
CT
Enumeration date
06/14/2017
Last updated
06/14/2017
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