| NPI | 1992914899 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1835X0200X Pharmacist, Oncology (Licence: TX 45396)  | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 21275)  | 
| Enumeration Date | 2007-05-21 | 
| Last Update Date | 2012-03-01 |