| NPI | 1568532695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 14682) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03321854) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2021-01-12 |