| NPI | 1033473962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: CA 10624) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH 60473776) |
| 183500000X Pharmacist (Licence: CA 76315) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2020-08-16 |