| NPI | 1033726294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 31878) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03439625) |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2023-05-24 |