| NPI | 1215361514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835X0200X Pharmacist Oncology (Licence: PA RP452207) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 53675) |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2020-12-14 |