| NPI | 1063968337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835X0200X Pharmacist Oncology (Licence: NC 26294) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 26294) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2022-07-21 |