| NPI | 1427334325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP446097) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0007753) |
| 183500000X Pharmacist (Licence: OH 03236783) | |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2021-03-25 |