| NPI | 1053045187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03442117) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 022996) |
| 183500000X Pharmacist (Licence: IN 26030024A) | |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2022-10-16 |