| NPI | 1598365736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP458278) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03316900) |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2025-02-13 |