| NPI | 1467796243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 06121) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 35273) |
| 183500000X Pharmacist (Licence: OH 03110827) | |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2012-11-19 |