NPI | 1891460739 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH61355356) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NC 30754) |
Enumeration Date | 2021-08-12 |
Last Update Date | 2023-02-07 |