| NPI | 1235216797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03-2-16433) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH 40879) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-04-16 |