| NPI | 1669354577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03445676) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0021031) |
| Enumeration Date | 2025-07-22 |
| Last Update Date | 2026-08-20 |