| NPI | 1821082488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03-1-23865) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: WV RP0006328) |
| 183500000X Pharmacist (Licence: WV RP0006328) | |
| 183500000X Pharmacist (Licence: KY 012669) | |
| 174H00000X Health Educator (Licence: KY 012669) | |
| 174H00000X Health Educator (Licence: OH 03-1-23865) | |
| 1835N0905X Pharmacist, Nuclear (Licence: WV rp0006328) | |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2024-03-04 |