| NPI | 1285082784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03135479) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 06011132) |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2023-07-21 |