| NPI | 1386721439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03-2-14021) |
| Additional Taxonomies | 1835N0905X Pharmacist, Nuclear (Licence: OH 03-2-14021) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |