| NPI | 1871328799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0200X Pharmacist, Pediatrics (Licence: WI 15529-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 15529-40) |
| Enumeration Date | 2024-09-03 |
| Last Update Date | 2024-09-03 |