NPI | 1417523515 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: WA 61099454) |
Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03440520) |
Enumeration Date | 2021-05-28 |
Last Update Date | 2023-10-30 |