| NPI | 1346469178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP438282) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03-1-24278) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2007-07-08 |