| NPI | 1548497449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP033785L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03324204) |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2009-06-18 |