| NPI | 1619590858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03131738) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26024584A) |
| 183500000X Pharmacist (Licence: KY 018364) | |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2023-11-04 |