| NPI | 1831540046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302027301) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03135436) |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2016-07-07 |