| NPI | 1376678599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835X0200X Pharmacist Oncology (Licence: FL PS0027491) |
| Additional Taxonomies | 305S00000X Point of Service (Licence: FL PS0027491) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2011-04-14 |