| NPI | 1932258324 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1835X0200X Pharmacist, Oncology (Licence: VA 0202013121)  | 
| Additional Taxonomies | 1835X0200X Pharmacist, Oncology (Licence: PA RP-029177-L)  | 
| 1835X0200X Pharmacist, Oncology (Licence: MD 15244)  | |
| Enumeration Date | 2007-01-09 | 
| Last Update Date | 2011-07-13 |