| NPI | 1861859530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03334829) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 023282) |
| 183500000X Pharmacist (Licence: IN 26026060A) | |
| Enumeration Date | 2016-01-26 |
| Last Update Date | 2026-03-14 |