| NPI | 1114300969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03334606) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 06010561) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2015-07-22 |