| NPI | 1073335337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: OH 03443369) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MI 5302415727) |
| Enumeration Date | 2024-10-28 |
| Last Update Date | 2024-10-28 |