NPI | 1174869598 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60292403) |
Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS45616) |
Enumeration Date | 2012-12-13 |
Last Update Date | 2014-11-22 |