| NPI | 1144711383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60836409) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2017024212) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2018-06-05 |