| NPI | 1033467709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0011744) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60098786) |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2012-08-28 |