| NPI | 1588106959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03136219) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 30129) |
| Enumeration Date | 2016-11-16 |
| Last Update Date | 2024-11-04 |