| NPI | 1033381009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: OH 03-3-25701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03-3-25701) |
| Enumeration Date | 2008-03-30 |
| Last Update Date | 2011-10-06 |