NPI | 1861634891 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60169096) |
Additional Taxonomies | 183500000X Pharmacist (Licence: CA 60224) |
Enumeration Date | 2009-04-06 |
Last Update Date | 2012-07-02 |