| NPI | 1467056390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03130873) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS47794) |
| Enumeration Date | 2020-11-22 |
| Last Update Date | 2020-11-22 |