| NPI | 1376882068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OH 031299951) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 031299951) |
| Enumeration Date | 2013-01-31 |
| Last Update Date | 2020-12-03 |