| NPI | 1184389850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03441278) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP456101) |
| Enumeration Date | 2021-11-07 |
| Last Update Date | 2021-11-07 |