| NPI | 1528848132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03443730) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P10953) |
| Enumeration Date | 2023-10-02 |
| Last Update Date | 2026-04-21 |