| NPI | 1982434759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03444213) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 024290) |
| Enumeration Date | 2024-08-06 |
| Last Update Date | 2024-08-06 |