| NPI | 1427199033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03-1-12128) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OH 1402) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2025-09-11 |