NPI | 1598210072 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60681503) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NV 19347) |
Enumeration Date | 2016-08-24 |
Last Update Date | 2019-10-23 |