| NPI | 1801175740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS49709) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03331189-3) |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2022-10-25 |