| NPI | 1215487798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835X0200X Pharmacist, Oncology (Licence: MA PH235232) |
| Additional Taxonomies | 1835X0200X Pharmacist, Oncology (Licence: OH 03233868-2) |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2016-10-10 |