| NPI | 1669203626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 91824) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03444623) |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2025-12-09 |