| NPI | 1669299863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2023007525) |
| Additional Taxonomies | 1835P0200X Pharmacist Pediatrics (Licence: IN 26026329A) |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: KS 1-16913) | |
| Enumeration Date | 2024-09-20 |
| Last Update Date | 2024-09-20 |