| NPI | 1902235799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: OH 03232872) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03232872-2) |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2023-10-02 |