| NPI | 1073266318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WA PHRM.PH.61672805) |
| Enumeration Date | 2022-01-27 |
| Last Update Date | 2026-06-23 |