| NPI | 1356658892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 36359) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03217969) |
| Enumeration Date | 2010-09-03 |
| Last Update Date | 2023-06-12 |