| NPI | 1609275395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AK 2257) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH RPH.03234054-2) |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2014-08-19 |