| NPI | 1477838423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 35969) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 15809) |
| 183500000X Pharmacist (Licence: OH 03-3-18448) | |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2016-06-23 |