| NPI | 1447241385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: OH 03-2-25131) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03-2-25131) |
| 1835G0303X Pharmacist, Geriatric (Licence: OH 032225131) | |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2012-07-06 |