| NPI | 1669245668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0200X Pharmacist, Pediatrics (Licence: DC PH200004391) |
| Additional Taxonomies | 1835P0200X Pharmacist, Pediatrics (Licence: FL PS58101) |
| Enumeration Date | 2023-11-01 |
| Last Update Date | 2023-11-01 |