| NPI | 1326525098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03216503) |
| Additional Taxonomies | 1835N1003X Pharmacist Nutrition Support (Licence: OH 03216503) |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2019-10-24 |