| NPI | 1023551934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0011236) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH00069634) |
| 183500000X Pharmacist (Licence: GA RPH019675) | |
| Enumeration Date | 2016-11-24 |
| Last Update Date | 2016-11-24 |