| NPI | 1245550730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH RPh03230485) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH INT. 06006492) |
| 183500000X Pharmacist (Licence: OH RPh.03230485-2) | |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2012-02-21 |