| NPI | 1437522497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03237517) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 25627) |
| Enumeration Date | 2015-11-12 |
| Last Update Date | 2020-06-25 |