| NPI | 1174068266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S022309) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03334793-3) |
| Enumeration Date | 2016-12-27 |
| Last Update Date | 2017-03-09 |