| NPI | 1912497371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835I0206X Pharmacist, Infectious Diseases (Licence: MA 1013078) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2023-08-31 |