| NPI | 1124656517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR PD14862) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 33239113) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2020-03-31 |