| NPI | 1427327824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S018762) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 033313413) |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2025-06-26 |