| NPI | 1457420457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835N1003X Pharmacist Nutrition Support (Licence: TX 25432) |
| Additional Taxonomies | 1835X0200X Pharmacist Oncology (Licence: TX 25432) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2007-07-08 |