| NPI | 1912310426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03232913-2) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 066008730) |
| 183500000X Pharmacist (Licence: MI 5302042097) | |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2014-06-03 |