| NPI | 1346377637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP029550L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03112245) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2007-07-08 |