| NPI | 1396057170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 0000027206) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03323815) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2010-07-08 |