| NPI | 1033767686 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 6382131-1701)  | 
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: UT 6382131-1701)  | 
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: UT 6382131-1701)  | |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: UT 6382131-1701)  | |
| 1835X0200X Pharmacist, Oncology (Licence: UT 6382131-1701)  | |
| Enumeration Date | 2019-08-27 | 
| Last Update Date | 2019-08-27 |