| NPI | 1952776189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP446757) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH RPH03230089-2) |
| 183500000X Pharmacist (Licence: DE A1-0004316) | |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2015-12-14 |