| NPI | 1538855549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03442954) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P10059) |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2023-04-12 |