| NPI | 1811107113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 17527) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: MD 17527) |
| 1835X0200X Pharmacist Oncology (Licence: MD 17527) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2007-07-08 |