| NPI | 1669690665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: MD 12607) |
| Additional Taxonomies | 1835X0200X Pharmacist Oncology (Licence: MD 12607) |
| 1835P1200X Pharmacist Pharmacotherapy | |
| 1835X0200X Pharmacist Oncology | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2007-07-08 |