| NPI | 1619593894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OH 03440169) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03440169) |
| 183700000X Pharmacy Technician (Licence: OH 06015533) | |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2023-05-11 |