NPI | 1245559228 |
---|---|
Former Name | KYLEY SHAIN BROWN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: WA 69473) |
Additional Taxonomies | 183500000X Pharmacist (Licence: MT 6554) |
Enumeration Date | 2010-05-29 |
Last Update Date | 2019-04-22 |