| NPI | 1235733148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03-1-20826) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP044684R) |
| Enumeration Date | 2020-11-23 |
| Last Update Date | 2020-11-23 |