| NPI | 1942476049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03-3-28569) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03328569) |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2020-07-31 |