| NPI | 1386269538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03337378) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 020084) |
| Enumeration Date | 2020-06-13 |
| Last Update Date | 2024-08-19 |