| NPI | 1548900285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03444198) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 022792) |
| 183500000X Pharmacist (Licence: NJ 28RI04312200) | |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2024-09-20 |