| NPI | 1265964241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: KY 019250) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 1835X0200X Pharmacist, Oncology (Licence: KY 019250) | |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2022-08-31 |