| NPI | 1629946835 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 14128-40) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: WI 14128-40) |
| 1835X0200X Pharmacist Oncology (Licence: WI 14128-40) | |
| Enumeration Date | 2025-10-28 |
| Last Update Date | 2025-10-28 |