| NPI | 1407131071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03331089) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: OH 03331089) |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2011-10-14 |