| NPI | 1760505689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: WA PH00039197) |
| Additional Taxonomies | 1835X0200X Pharmacist, Oncology (Licence: WA PH00039197) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2007-07-08 |