| NPI | 1922524263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302046447) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03237429-2) |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2022-10-28 |