| NPI | 1356773527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 53551) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 14271) |
| 183500000X Pharmacist (Licence: ID P8987) | |
| 183500000X Pharmacist (Licence: OH 03440107) | |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2023-02-24 |