| NPI | 1003197500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03225434) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP440990) |
| 183500000X Pharmacist (Licence: IL 051.291800) | |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2011-08-30 |