| NPI | 1609090307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS57222) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03-1-27585) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2022-10-26 |