| NPI | 1184829285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 13846) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03-1-20463) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2010-10-18 |