| NPI | 1750024865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03-2-13120) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03213120) |
| Enumeration Date | 2022-04-16 |
| Last Update Date | 2023-08-18 |