| NPI | 1558641449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03331294) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26024778A) |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2014-03-16 |