| NPI | 1851922793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03438387) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL 60552) |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2020-12-14 |