| NPI | 1225468986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S020257) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03232869) |
| Enumeration Date | 2013-11-17 |
| Last Update Date | 2022-12-19 |