| NPI | 1952706749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH RPH.03331298-3) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: OH 3120383) |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2014-10-23 |