| NPI | 1366628737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MT 5317) |
| Additional Taxonomies | 1835G0303X Pharmacist Geriatric (Licence: MT 5317) |
| 1835X0200X Pharmacist Oncology (Licence: MT 5317) | |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2008-01-16 |