NPI | 1619676145 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH238139) |
Additional Taxonomies | 1835P0200X Pharmacist, Pediatrics (Licence: MA 8151440) |
Enumeration Date | 2023-02-23 |
Last Update Date | 2023-02-23 |