| NPI | 1558514687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835X0200X Pharmacist Oncology (Licence: NY 050158-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 050158-1) |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2018-02-22 |