| NPI | 1740589936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03234142) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: OH 201196) |
| 183500000X Pharmacist (Licence: WI 16669-40) | |
| 183500000X Pharmacist (Licence: IL 051296556) | |
| 1835E0208X Pharmacist, Emergency Medicine (Licence: OH B14100311) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: OH 3131459) | |
| 1835C0205X Pharmacist, Critical Care (Licence: OH 7150762) | |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2026-07-09 |