| NPI | 1528306107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS48911) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ 16624) |
| 183500000X Pharmacist (Licence: OH RPH.03135335-1) | |
| Enumeration Date | 2013-01-16 |
| Last Update Date | 2017-01-09 |