| NPI | 1104160696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA P00007966) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: WA P00007966) |
| Enumeration Date | 2012-11-21 |
| Last Update Date | 2012-11-21 |