| NPI | 1013946631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835N0905X Pharmacist Nuclear (Licence: FL PS 20724) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: FL PS 20724) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2007-07-08 |