| NPI | 1861959140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 020188) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26027842A) |
| 183500000X Pharmacist (Licence: OH 03438344) | |
| Enumeration Date | 2019-02-22 |
| Last Update Date | 2019-02-22 |