| NPI | 1447741541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 19430) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR 0015742) |
| 183500000X Pharmacist (Licence: WA 60720539) | |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2018-05-23 |