NPI | 1689337644 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH61341288) |
Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2021034115) |
183500000X Pharmacist (Licence: KS 1-103678) | |
Enumeration Date | 2021-10-18 |
Last Update Date | 2022-12-27 |