| NPI | 1588286629 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1835X0200X Pharmacist, Oncology (Licence: FL 56248)  | 
| Additional Taxonomies | 1835X0200X Pharmacist, Oncology (Licence: NC 22858)  | 
| Enumeration Date | 2020-05-12 | 
| Last Update Date | 2020-05-12 |