| NPI | 1396044335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03-2-34165) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0014214) |
| 183500000X Pharmacist (Licence: KY 017442) | |
| 183500000X Pharmacist (Licence: OR RPH-0014970) | |
| 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OR RPH-0014970) | |
| Enumeration Date | 2011-03-16 |
| Last Update Date | 2024-08-10 |