| NPI | 1700016581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP030449L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03-3-10718) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2009-07-15 |