| NPI | 1093088049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AK 1795) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH0011378) |
| 183500000X Pharmacist (Licence: WA PH60094526) | |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2023-05-18 |