| NPI | 1023553062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835N1003X Pharmacist, Nutrition Support (Licence: CA 43214) |
| Additional Taxonomies | 1835X0200X Pharmacist, Oncology (Licence: CA 43214) |
| Enumeration Date | 2016-12-29 |
| Last Update Date | 2016-12-29 |