| NPI | 1154934917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03439862) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26027566A) |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2020-08-31 |