| NPI | 1427813377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03328653) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS56594) |
| Enumeration Date | 2024-02-20 |
| Last Update Date | 2024-02-20 |