| NPI | 1871897231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03225227) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP441783) |
| Enumeration Date | 2010-12-28 |
| Last Update Date | 2024-05-14 |