| NPI | 1164546768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NV 16175) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: OH 03-1-24589) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-08 |