| NPI | 1689088270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH RPH.03233688) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26024972A) |
| 183500000X Pharmacist (Licence: KY 015980) | |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2014-06-11 |