| NPI | 1134494115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60214328) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH0012685) |
| Enumeration Date | 2012-03-09 |
| Last Update Date | 2023-11-29 |