| NPI | 1699349027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03440490) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 14255) |
| 183500000X Pharmacist (Licence: SC 11316) | |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2021-05-19 |