| NPI | 1497250732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 3236869) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 123364) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2018-03-28 |