| NPI | 1356653737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03230101) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302040202) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2024-03-13 |