| NPI | 1407248826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03230524) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 016382) |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2015-02-23 |