| NPI | 1033254701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL ps0020661) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03315522) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2007-07-09 |