| NPI | 1508110792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 43052) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: TX 43052) |
| 1835X0200X Pharmacist, Oncology (Licence: TX 43052) | |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2012-11-09 |