NPI | 1043829906 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: ID P8920) |
Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH61049973) |
Enumeration Date | 2020-07-27 |
Last Update Date | 2021-12-13 |