| NPI | 1558413609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835X0200X Pharmacist Oncology (Licence: HI 877) |
| Additional Taxonomies | 1835X0200X Pharmacist Oncology (Licence: CA 37557) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2007-07-08 |