| NPI | 1134474190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WA PH60367788) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 21688) |
| 183500000X Pharmacist (Licence: NE 13947) | |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: IA 21688) | |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NE 13947) | |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2013-07-13 |