| NPI | 1629138912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 33739) |
| Additional Taxonomies | 1835X0200X Pharmacist, Oncology (Licence: TX 33739) |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2009-06-13 |