| NPI | 1326448556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 0020365) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03233879) |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2014-08-25 |