| 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 |