| NPI | 1073233995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS64388) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0010558) |
| 183500000X Pharmacist (Licence: OH 03237224) | |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2022-08-31 |