| NPI | 1093428864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH61362363) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P10288) |
| Enumeration Date | 2022-12-27 |
| Last Update Date | 2022-12-27 |