| NPI | 1174299267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: KY 022239) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OH 03441515) |
| 183500000X Pharmacist (Licence: KY 022239) | |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2026-06-18 |