| NPI | 1821422445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835N0905X Pharmacist, Nuclear (Licence: OH 03230103) |
| Additional Taxonomies | 1835N0905X Pharmacist, Nuclear (Licence: KY 015263) |
| Enumeration Date | 2013-08-30 |
| Last Update Date | 2015-01-03 |