| NPI | 1639831324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03228244) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP449413) |
| Enumeration Date | 2021-10-10 |
| Last Update Date | 2021-10-10 |