| NPI | 1326439209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 42468) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03234026) |
| 183500000X Pharmacist (Licence: NC 25552) | |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2022-10-27 |