| NPI | 1982012175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: DC PH10001750) |
| Additional Taxonomies | 1835X0200X Pharmacist, Oncology (Licence: DC PH10001750) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2023-08-29 |