| NPI | 1750558714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 79766) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03-2-27765) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2023-01-11 |