| NPI | 1902152382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0013279) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH RPH.03131777-1) |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2013-11-04 |