NPI | 1679140024 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60957281) |
Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: WA PH60957281) |
Enumeration Date | 2021-06-04 |
Last Update Date | 2021-06-17 |