NPI | 1891041604 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH70715) |
Additional Taxonomies | 183500000X Pharmacist (Licence: CA 62095) |
Enumeration Date | 2012-07-30 |
Last Update Date | 2012-07-30 |