| NPI | 1811590730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH033584) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03439186) |
| Enumeration Date | 2020-11-21 |
| Last Update Date | 2024-10-03 |