| NPI | 1588085393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DC PH100001472) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03233056) |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2013-12-20 |