| NPI | 1043937261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03216412) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP036204R) |
| Enumeration Date | 2022-10-27 |
| Last Update Date | 2022-10-27 |