| NPI | 1013399567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03334747) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 06010300) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2018-03-17 |