| NPI | 1639551088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03334603-3) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03334603) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2020-11-30 |