| NPI | 1679514558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: IL 051.289787) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: OH 03-2-25261) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2007-07-08 |