| NPI | 1043280662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS 53874) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03-2-15386) |
| 183500000X Pharmacist (Licence: CA 43293) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2017-07-22 |