| NPI | 1902460553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0200X Pharmacist, Pediatrics (Licence: AZ S023990) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 183500000X Pharmacist (Licence: AZ S023990) | |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2020-07-15 |