| NPI | 1821694969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03237117) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 019232) |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2020-12-04 |