| NPI | 1083730667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS31225) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03-1-08631) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2007-07-08 |