| NPI | 1699288720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WV 0008205) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03233264) |
| Enumeration Date | 2017-11-11 |
| Last Update Date | 2017-11-11 |