| NPI | 1568905495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR PD12515) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03-2-33562) |
| 183500000X Pharmacist (Licence: NC 24001) | |
| Enumeration Date | 2016-11-26 |
| Last Update Date | 2016-11-26 |