| NPI | 1912216920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03233039) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 18533) |
| Enumeration Date | 2010-09-26 |
| Last Update Date | 2023-10-16 |