| NPI | 1457806291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S018636) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH RPH.03330988-3) |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2016-08-22 |