| NPI | 1457849366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03439138) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 020319) |
| 183500000X Pharmacist (Licence: CA 77068) | |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2020-04-24 |