| NPI | 1598850927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WV RP00004093) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP037260R) |
| 183500000X Pharmacist (Licence: OH 03-3-14317) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |