NPI | 1689302887 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: NV 23048) |
Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH61434840) |
Enumeration Date | 2022-08-15 |
Last Update Date | 2025-03-09 |