| NPI | 1558421164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 11735) |
| Additional Taxonomies | 1835N0905X Pharmacist, Nuclear (Licence: MD 11735) |
| 1835X0200X Pharmacist, Oncology (Licence: AL 18403) | |
| 1835X0200X Pharmacist, Oncology (Licence: MI 5302043576) | |
| 1835X0200X Pharmacist, Oncology (Licence: AR PD12444) | |
| 1835X0200X Pharmacist, Oncology (Licence: WV RP0008642) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2015-07-17 |