| NPI | 1043736937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH00010428) |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate |
| 164W00000X Licensed Practical Nurse (Licence: WA LP00016283) | |
| 1835C0205X Pharmacist Critical Care (Licence: WA PH00010428) | |
| 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WA PH00010428) | |
| 1835P2201X Pharmacist Ambulatory Care (Licence: WA PH00010428) | |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2022-07-21 |