| NPI | 1598051690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03127348) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 013553) |
| 183500000X Pharmacist (Licence: VA 0202204774) | |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2011-06-27 |