| NPI | 1932659653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03334666) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 017854) |
| 183500000X Pharmacist (Licence: MI 5302043608) | |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2016-10-05 |