| NPI | 1952299356 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 60252) |
| Additional Taxonomies | 1835P0200X Pharmacist, Pediatrics (Licence: GA RPH035516) |
| Enumeration Date | 2025-06-25 |
| Last Update Date | 2025-06-25 |