| NPI | 1760552095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 12257) |
| Additional Taxonomies | 1835X0200X Pharmacist, Oncology (Licence: TX 26811) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2007-07-08 |