| NPI | 1043562440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WA 60314416) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA RPH-0013241) |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2026-05-27 |