| NPI | 1386791309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: TX 43435) |
| Additional Taxonomies | 1835X0200X Pharmacist, Oncology (Licence: TX 43435) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2007-07-08 |