NPI | 1952678872 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03228264) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: OH pt009519) |
Enumeration Date | 2011-11-21 |
Last Update Date | 2011-11-21 |