| NPI | 1316833510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03444896) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 90286) |
| Enumeration Date | 2025-06-16 |
| Last Update Date | 2025-06-16 |