| NPI | 1891457701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: OH 03441860) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: CA RPH85184) |
| Enumeration Date | 2021-10-07 |
| Last Update Date | 2023-08-02 |