| NPI | 1033580063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835X0200X Pharmacist, Oncology (Licence: NY 059920) |
| Additional Taxonomies | 1835X0200X Pharmacist, Oncology (Licence: TX 53244) |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2015-10-16 |